| Incidence of contrast-induced nephropathy in patients with chronic renal insufficiency undergoing multidetector computed tomographic angiography treated with preventive measures. | |
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MedLine Citation:
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PMID: 18638601 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Contrast-induced nephropathy (CIN) is associated with adverse outcomes. Strategies for its prevention have been evaluated for patients undergoing invasive coronary and peripheral angiography, including treatment with N-acetylcysteine, sodium bicarbonate, and use of iso-osmolar nonionic contrast. Recently, multidetector computed tomographic angiography (MDCTA) of the coronary and peripheral arteries has been introduced as an accurate method for assessing vascular stenosis and has been widely adopted for assessment of outpatients with suspected coronary artery disease or peripheral arterial disease. To date, the incidence of CIN in outpatients with chronic renal insufficiency (CRI) treated with CIN-preventive strategies undergoing MDCTA remains unknown. Thus, we evaluated the incidence of CIN in outpatients with CRI (creatinine 1.5 to 2.5 mg/dl) undergoing MDCTA using CIN-preventive measures; 400 patients with CRI (78.5% men, mean age 76 years, 41% with diabetes) underwent MDCTA with iodixanol for detection of coronary artery disease or peripheral arterial disease (mean contrast volume 101 cc). CIN was defined as a nonallergic creatinine increase of >0.5 mg/dl. Creatinine levels were obtained before and 3 to 5 days after MDCTA; the average creatinine levels were 1.80 mg/dl and 1.75 mg/dl, respectively (p = NS), with an average change of -0.03 mg/dl. In the study cohort, only 7 patients (1.75%) experienced a creatinine increase >0.5 mg/dl, satisfying the definition of CIN. In conclusion, multivariate analysis, diabetes was the only predictor for CIN (odds ratio 5.9, 95% confidence interval 1.0 to 33.3, p = 0.045). No patient required hemodialysis. In conclusion, in patients with CRI undergoing MDCTA and receiving CIN-preventive measures, the incidence of CIN is low. |
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Authors:
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Mohammad El-Hajjar; Iqbal Bashir; Muhammad Khan; James Min; Mikhail Torosoff; Augustin DeLago |
Publication Detail:
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Type: Journal Article Date: 2008-05-29 |
Journal Detail:
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Title: The American journal of cardiology Volume: 102 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-07-21 Completed Date: 2008-09-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 353-6 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiology, Department of Medicine, Albany Medical College, Albany, New York, USA. el-hajm@mail.amc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acetylcysteine
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therapeutic use Aged Angiography / methods* Contrast Media / adverse effects* Coronary Angiography / methods Creatinine / metabolism Female Humans Kidney Diseases / chemically induced*, prevention & control* Kidney Failure, Chronic / complications* Male Sodium Bicarbonate / therapeutic use Tomography, X-Ray Computed / methods* Triiodobenzoic Acids / adverse effects |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 0/Triiodobenzoic Acids; 144-55-8/Sodium Bicarbonate; 60-27-5/Creatinine; 616-91-1/Acetylcysteine; 92339-11-2/iodixanol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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